Genital Herpes in Pregnancy

A healthy pregnancy is what every expecting mother wishes for, but there are a few conditions that can be a cause for concern during pregnancy. One such concern we are going to discuss today is genital herpes in pregnancy. It is a sexually transmitted infection caused by HSV or herpes simplex virus.

Pregnancy and Genital Herpes

Genital herpes can be caused by two types of viruses, HSV 1 and HSV 2. The symptoms include blisters or sores in and around the genital area, which can sometimes be found around the anal area and even thighs. A pregnant woman with genital herpes can transfer this virus to her newborn baby if there is an outbreak just before birth. Therefore, if you are pregnant with genital herpes, then you need to exercise great caution so that the infection does not get passed on to the baby.

How Does It Spread?

Genital herpes can spread after coming in physical contact with the infected person. HSV-1 and HSV-2 can both cause genital herpes. The herpes simplex virus, or HSV, can be transferred from a person who has genital herpes to a healthy person through vaginal, anal or oral sex.

This virus cannot be passed on by using common toilet seats, bathtubs, or toiletries as the HSV is unable to survive long on non-living objects.

Symptoms

The symptoms of genital herpes in the first stage often go unnoticed and unrecognized as people often mistake it for an itch, insect bite, abrasions or yeast infection.

However, the very first symptoms of genital herpes can be visible as early as two to three days after catching the infection or as late as after a month. There is an outbreak of blisters and sores in and around the genital area.

The symptoms are as follows:

• There is a tingling sensation or itching before the outbreak of any blister occurs.
• The appearance of blisters can be seen on the vagina, anus, and buttocks. If the infection is through oral sex, then the lips, mouth, and face get affected.
• The blisters at a later stage turn into ulcers.
• These oozing ulcers form a crust after a few days.
• There may be swelling and pain in the lymph glands.

Causes

The main cause of genital herpes is HSV- 2, which can be passed during vaginal or anal sex. HSV-1, which causes oral herpes, can also become the cause of genital herpes in some cases. The HSV-1 virus can be passed from the mouth to the genitals during oral sex. Thus HSV-1 and HSV-2 can both be a cause of genital herpes.

In cases of recurrent infections, the following may be possible triggers:

• A weak immune system makes it easier for the virus to attack the body and place itself.
• Consuming excessive amounts of alcohol can harm your immune system and thus trigger the virus
• Stress is known to be a trigger for herpes. Scientists are still to find a reason as to why it is caused, but studies have proven that it does have an impact
• Any surgical procedure on the genital area may cause herpes to return because the nerve cells around the area could get inflamed and activate the dormant virus.

Complications

In most cases, genital herpes does not cause serious complications, but in some cases, it does.

Genital herpes during pregnancy may cause serious complications leading to

• Infection in newborn babies- Herpes virus can be passed on to the baby during birth which may lead to blindness, brain damage and, in some cases, death.
• Meningitis- Herpes virus may even lead to inflammation of membranes around the brain and spinal cord, which may result in this fatal condition.
• Sexually transmitted disease- This infection may increase your chances of catching or transmitting other sexually transmitted diseases.
• Problems in the bladder- Herpes may cause inflammation around the bladder also, which can be extremely painful and discomforting.

Diagnosis

A physical examination and a few lab tests will help a doctor diagnose genital herpes. The tests include:

• Blood test – It will help determine the presence of HSV.
• PCR (Polymerase Chain Reaction) Test – This is used to copy DNA from the blister, blood or fluid from the spine to find out which type of HSV is present.
• Tissue Culture – A tissue scrapped from the sore or blister can be examined.

Treatments

Treatment for genital herpes includes separate treatments for:

1. Primary Infections

If someone is infected for the first time (primary infection), the doctor will administer oral anti-viral medicine can be prescribed depending on the severity of the infection.

2. Recurrent Infections

In case of recurrent infections, the anti-viral medicine can be prescribed for a longer duration along with a few precautions that need to be exercised on a regular basis, such as:

• Cleaning the affected area with warm water: This ensures hygiene and can also help alleviate the effects of the infection and discomfort.
• Applying ice packs: Cold treatment around the affected area on a regular basis helps provide relief.
• Applying prescribed ointments: These are medicated ointments that help dry the ulcers and treat the affected region.
• Drinking plenty of fluids: Keeping yourself hydrated is the primary step to the treatment, which will also ensure the skin is well nourished.
• Abstaining from wearing tight clothing: Tight clothing will put pressure on the affected area, causing the pain, irritation and condition to worsen. Instead, opt for loosely fitted cotton or linen fabrics that allow the skin to breathe.

Can Herpes Affect the Baby?

Herpes can affect the newborn baby in the following ways

• Skin, eyes and mouth infection – most babies may develop sores around their eyes, mouth and on their skin if they get infected. However, no major complications arise if the baby receives prompt treatment.

• Disseminated diseases – The baby with the herpes virus may get a disseminated disease that affects multiple organs, majorly the lungs and liver. This is a fatal condition with a low survival rate.

• Central nervous system diseases – Babies may show lethargy, irritability, disinterest in feeding, fever or seizures if they catch the herpes virus.

What If Women Get Herpes After Pregnancy?

Can herpes affect/ terminate the pregnancy if a pregnant woman gets infected? No, it does not stop the pregnancy, but if a pregnant woman gets genital herpes, then there is a risk of transmitting the infection during labour/delivery. Though the chances are as dim as 1 in 10, the risk of passing the infection to a newborn baby increases if a pregnant woman gets herpes in the third trimester. Also, in rare cases, when a pregnant woman gets infected in the first trimester, the virus may travel to the placenta and lead to miscarriage or cause birth defects.

What If Your Husband Has Herpes?

If your husband has herpes, it is very important to exercise great caution throughout the pregnancy, such as:

• Use condoms while having sex
• Refrain from oral sex
• Avoid any skin-to-skin contact with your husband’s genitals
• Refrain from sexual intercourse and other sexual contacts in the third trimester.

If The Baby Catches Herpes, Does It Affect The Baby?

When a newborn baby gets infected, it is called neonatal herpes. It is a rare condition, but this could result in skin, eyes or mouth infections. Herpes can also affect the baby’s brain, nerves, and other organs. Timely treatment can be helpful, but certain conditions can become life-threatening.

Can Herpes-Infected Moms Breastfeed?

It is safe to breastfeed if you have herpes, as the infection is not transferred through breast milk. However, you must exercise caution when you have a blister or sore on the following body parts:

1. Mouth – Refrain from kissing the baby until it is cured.

2. Breast – If you have blisters on one breast, then you can feed from the other breast. If both breasts are infected, then it is advised to give formula milk till the sores are completely healed.

3. Other parts of the body – Keep the area covered, and do not let the baby touch it.

Ways To Avoid Herpes

Genital herpes spreads by the virus coming into contact with the infected person. This could be in the form of vaginal, anal and oral sex.

Therefore, if your husband has this infection, then the following are a few ways to avoid getting this infection:

• Protected sex no sex close to delivery
• Do not receive oral sex
• The moment any symptom is observed, get medical help

Genital herpes and getting pregnant may pose some complications in the pregnancy. However, if you are wondering, ‘can I get pregnant if I have herpes’, the answer is yes. However, you need to be careful throughout your pregnancy so that the infection is not passed on to your unborn child in the womb or while in labour.

A healthcare practitioner should be contacted as soon as you establish that you have genital herpes so that herpes pregnancy treatment can start without any delay.

References/Resources:

1. Genital herpes in pregnancy patient information leaflet; RCOG; https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/genital-herpes-in-pregnancy-patient-information-leaflet/#:~:text=If%20you%20have%20caught%20genital,your%20baby%20is%20extremely%20low

2. Genital herpes in pregnancy; Institute for Quality and Efficiency in Health Care; NCBI; https://www.ncbi.nlm.nih.gov/books/NBK525779/, July 2018

3. Herpes and Pregnancy; ASHA; https://www.ashasexualhealth.org/herpes-and-pregnancy/

4. Genital herpes and pregnancy: Understanding the risks; Your Pregnancy Matters; UT Southwestern Medical Center; https://utswmed.org/medblog/genital-herpes-pregnancy-faqs/, August 2020

5. Management of Genital Herpes in Pregnancy; Royal College of Obstetricians and Gynaecologists; https://www.rcog.org.uk/guidance/browse-all-guidance/other-guidelines-and-reports/management-of-genital-herpes-in-pregnancy/, 2014

Also Read:

Anal Sex While Pregnant
Bacterial Vaginosis in Pregnancy